In a recent report to Congress, the Office of the National Coordinator of Health IT (ONC) indicated that the mission of its 62 regional extension centers (REC) has grown to encompass support for physicians in a number of areas, including Meaningful Use stages 2 and 3 and other federal programs. In an interview with InformationWeek Healthcare, officials of the New Jersey REC, known as NJ-HITEC, explained how their organization is expanding and changing in response to emerging provider needs.

NJ-HITEC has enrolled about 7,800 eligible professionals, including hundreds of specialists who pay the REC for help in achieving Meaningful Use of their electronic health records (EHRs). Of the 6,397 primary care providers (PCPs) who have signed up with the REC -- 1,000 more than the ONC's goal -- nearly 6,200 have gone live with their EHRs and 3,062 have attested to Meaningful Use. That's the largest number for any REC in the country, according to Bill O'Byrne, executive director of NJ-HITEC.

Of the 800 NJ-HITEC members who attested to Meaningful Use stage 1 in 2011, the first year of the program, about 650 attested in 2012. Although ONC does not fund the RECs to help EPs show Meaningful Use in the second year, NJ-HITEC encourages its enrollees to stay in touch and is willing to answer questions they have about the program. Recently, it was reported that 20% of physicians who attested nationally in 2011 did not re-attest in 2012.

Meanwhile, facing a cutoff in government funding on April 1, 2014, NJ-HITEC is converting itself into a membership organization. For a fee of $500 per provider per year, members will receive help in meeting the Meaningful Use Stage 2 and 3 goals; 400 physicians have already plunked down their money in advance, O'Byrne said.

Both ONC-funded and self-paid members have access to a member portal that features a plethora of services. Among these are educational materials; cloud-based storage of MU data and documents; audit preparation; security and privacy assessments and remediation services; Direct secure messaging; mobile access to MU data on smartphones and iPads; and an electronic registry that submits MU quality data to the Centers for Medicare and Medicaid Services (CMS).

CMS recently approved the NJ-HITEC registry, noted O'Byrne. The registry can be used to report clinical quality measures, not only for the Meaningful Use program, but also for the Physicians Quality Reporting System (PQRS), which awards incentives to participating doctors, he said. In addition, he said, it can be used to report quality data for patient-centered medical homes and for participants in CMS' Comprehensive Patient Care (CPC) initiative. A public-private demonstration project designed to foster care coordination, CPC involves nearly 300 PCPs in New Jersey, of whom 90% are NJ-HITEC members, he said.

With new funding from CMS, the RECs in Arkansas, New Jersey, New York, and Cincinnati are all supporting the health IT aspect of CPC. In O'Byrne's view, the big advantage that the RECs have here is that they have worked before with most of these doctors and can help them translate their MU know-how into practical applications of their EHRs. Along the way, they can use the same skills to build patient-centered medical homes and perhaps even accountable care organizations.

"We've been talking to the CPC doctors about ways to use their EHRs not only to achieve the milestones for CPC -- which are not far different from those of Meaningful Use stage 2 -- but also to achieve PCMH status and later, perhaps, to help them become a member of an ACO," he said.

NJ-HITEC is already working with two ACOs, both owned by Barnabas Health, New Jersey's largest healthcare system. ACOs must report quality data to CMS by enrolled patient, rather than physician, so Barnabas contracted the REC to help the doctors generate that data from their EHRs, O'Byrne said. NJ-HITEC is also in discussions with several other ACOs, he said.

The REC's advantage lies in its relationships with physicians. "We are the one organization in N.J. that has trained and educated boots on the ground to go out and work in doctors' offices," O'Byrne pointed out.

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